Tibial Hemimelia: Challenges in Management in a Resource Constrained Region

Abstract

Introduction: Tibial Hemimelia is a rare congenital deformity which is associated with challenges in management. We document our experience and demonstrate the influence of socio-cultural beliefs in the management. Patients and Method: The clinical information of all the patients were retrieved from the patient medical records from 1st of November 2016 – 31st October 2020. Results: Three patients with four cases of Tibial Hemimelia were managed during this period. One of the patients had bilateral deformities with upper limb involvement and associated bilateral clubfeet. This patient had positive family history of congenital deformity. The mothers were below 30 years of age with one of them being HIV positive. They were all males. One was delivered via cesarean section. No history of maternal ingestion of unprescribed drugs. All the cases were seen and counseled in our hospital regarding treatment options, outcomes and the consequences of not adhering to treatment. Despite counseling and initiation of treatment, two of the patients were lost to follow up. Conclusion: Tibial Hemimelia is a rare deformity worldwide with numerous treatment options with guided outcomes. There is need for support systems to be put in place, parental counseling and empathy cannot be over emphasized.